Remedies for Endometriosis
Drugs that suppress the activity of the
ovaries and slow the growth of endometrial tissue
Some doctors recommend the long-term use of low-estrogen,
high-progestin birth control pills, unless a woman is trying to get pregnant. These pills
are deliberately used to lighten or sometimes even stop periods and appear to help keep
stray endometrial tissue from growing. Of the drugs used for endometriosis, birth control
pills have the mildest side effects.
Drugs that suppress the body's production of estrogen may also be used
to control endometriosis. Danazol (Danocrine) is a powerful drug similar to the hormone
testosterone. Danazol has been shown to improve symptoms for 89 percent of women who take
it and to reduce the size and number of implants. It works by reducing FSH and LH levels.
It is taken for six to nine months at a time. However, women who use it may experience
side effects including pseudo-menopause, hot flashes, a dry vagina, joint pain, weight
gain, depression, irritability, fatigue, and voice changes. In extreme cases, side effects
may include masculinization. There is a high rate of recurrent pain after pregnancy for
those who conceive after this treatment. In addition, over 30% of these women have some
kind of problem with fertility later on. Because of its many serious side effects, Danazol
is seldom used these days.
The two most commonly used drugs are derived from
gonadotropin-releasing hormone, a naturally occurring brain hormone. They are called
gonadotropin-releasing hormone agonists (GnRH-a for short).
These drugs shut down secretion of LH and FSH by overloading the pituitary's production
facilities. In effect, the GNRH analogs put an end to ovulation without removing the
ovaries. The near menopausal state that results stops menstruation and the growth of
endometrial tissue, and reduces the pain of endometriosis. Of course, it also brings with
it the problems of estrogen deficiency, ranging from hot flashes and headaches to
increased risk of osteoporosis. These problems can be halted by going off these
medications, and fertility then appears to be regained.
GNRH analogs can be taken as a nose spray Nafarelin (Synarel), as a
daily or monthly injection Leuprolide (Lupron), or as a monthly implant beneath the skin
(Zoladex). A course of treatment lasts 6 months.
Nafarelin, available as a nasal spray called Synarel, relieves symptoms
and helps shrink endometrial lesions. In a trial involving 247 women treated with
nafarefin for six months, 85 percent had their implants shrink or disappear and their
symptoms relieved. Six months after treatment, however, symptoms reappeared in half of
those who had been helped. Possible side effects are similar to some of the discomforts of
menopause, including hot flashes, vaginal dryness, and lighter, less frequent, or no
menstruation. Other effects include headaches and nasal irritation.
An injectable drug named leuprolide (Lupron) is similar to
Treatment consists of one injection a month for six months. In clinical studies, the
effectiveness of leuprolide has been found to be about the same as that of
according to the manufacturer. Potential side effects are similar to those caused by
In addition to pain-relief medications available over-the-counter, a
number of prescription products can be used to reduce the pain of endometriosis.
These drugs, called nonsteroidal anti-inflammatories include Naprosyn, Feldene,
Ponstel, Rufen, Clinoril, Motrin, Nalfon, Dolobid, Meclomen, Tolectin, and
pain-killers such as codeine, oxycodone, meperidine and morphine, as well as narcotics
combined with other pain relief drugs, may also be prescribed.